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WHAT IS EPAT? Extracorporeal Pulse Activated Technology is a non-surgical treatment option for persistent pain associated with chronic plantar fasciosis, achilles tendinosis, and several other chronic musculoskeletal conditions. Shockwave, also known as pressure or sound waves, are generated by a special EPAT device, and focused onto the targeted tissue, The shock waves are delivered to stimulate and reactivate the body's repair mechanisms to advance normal tissue healing.

BEFORE EPAT: Discontinue taking all medications containing aspirin or non- steroidal anti-inflammatory medications one week prior to EPAT treatment.

SIDE EFFECTS: Compared to invasive or endoscopic surgery, EPAT has fewer side effects and a much shorter recovery time. The most common side effects include temporary pain (bruising and soreness), swelling and petechiae (broken blood vessels that are generally of no concern). These possible occurrences, however, usually clear within a few days. Moreover, the risks associated with surgical incisions and general anesthesia are eliminated.

TREATMENTS: Typical is 3 treatments a week, but treatment regiment can vary.

AFTER TREATMENT: You will be allowed to leave the office with a supportive walking shoe on with your orthotics (if available).

So what is PRP? Most everyone thinks of blood platelets as being responsible for blood clotting after any type of injury. This is true, but they also have two other important functions. One, they are responsible for bringing white blood cells to the injured area to clean up remains of dead and injured cells. The second function is they release bioactive proteins known as growth factors. These growth factors send out chemical signals that organize and coordinate the various cells needed for tissue repair. In other words, they are the managers of the entire wound healing process. Unlike other treatments we are using your bodies own growth factors to encourage ingrowth of normal collagen and the remodeling of the previously injured tissue at the pain initiating site.

PRP has been used at many hospitals in Colorado for orthopedic procedures, neurosurgery procedures, plastic surgery and chronic wound care with great success. PRP has been used across the country for the treatment of chronic foot and ankle pain: Plantar fasciitis, achilles tendinosis, posterior tibial tendinoses as well as chronic wounds with the goal of regenerating degenerative connective tissue with reports of success.

What is involved with a PRP treatment? This procedure is done in our office under sterile technique. Approximately 3-4 tablespoons of your blood is drawn immediately prior to the procedure. The blood is placed in a special centrifuge for 15 to 20 minutes that concentrates the platelets 4-8 times the baseline values. This higher than normal concentration of platelets is what gives us platelet rich plasma. The PRP is then drawn into a syringe. The area to be treated is injected with a local anesthetic. Once the anesthetic has taken effect then the PRP is injected into the area of pain/injury. Sometimes an ultrasound is utilized to help provide some guidance to the area of the injury. Immediate ambulation is allowed after this procedure.